This used to be called Hyperosmolar Non-Ketotic State (HONK).
It is very serious, but uncommon disorder seen typically in people with Type 2 Diabetes. It can also occur in people with type 1 diabetes, but less commonly.
Compared with DKA, these people present with more severe dehydration, hyperglycaemia and more serious comorbidities. It is associated with a higher mortality rate than DKA due to the patients’ age and comorbidities.
The diagnosis of HHS is based on the results of venous blood:
Confirmatory tests: Capillary ketones <3 mmol/L
Acute Management of Hyperosmolar Hyperglycaemic state (HHS, or HONK)